How much rates vary
Facilitymedian $1,738 · 10th to 90th $933 to $3,715Professionalmedian $1,023 · 10th to 90th $661 to $1,660
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $933.25 Median $1,023.29 Typical High $6,918.31 | Facility | None | $933.25 | $1,023.29 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,071.52 | Professional | None | $912.01 | $1,023.29 | $1,071.52 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,090.30 | Facility | None | $1,737.80 | $1,778.28 | $3,090.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $1,122.02 Typical High $1,659.59 | Professional | None | $190.55 | $1,122.02 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,071.52 Typical High $2,398.83 | Professional | None | $602.56 | $1,071.52 | $2,398.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,041.74 Median $2,570.40 Typical High $4,897.79 | Facility | None | $2,041.74 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,230.27 | Professional | None | $831.76 | $1,023.29 | $1,230.27 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,202.26 | Professional | None | $602.56 | $933.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,318.26 | Professional | None | $891.25 | $977.24 | $1,318.26 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $478.63 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $190.55 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $707.95 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $724.44 |
Where Michigan sits
The same service costs 3.2 times more in Oklahoma than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
OK $7,412MD $2,297
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.